NPI | 1376535724 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD16022) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60965635) |
207RG0100X Internal Medicine, Gastroenterology (Licence: CA G74500) | |
Enumeration Date | 2005-08-19 |
Last Update Date | 2024-11-04 |